Abstract: A noise discrimination circuit determines if sensed electrocardiographic (ECG) pulsed signals sensed within a pulse generator are valid ECG signals, i.e., valid P-waves or R-waves, or noise. The ECG signal may then be processed. The processed ECG signal is monitored to determine both the amplitude and duration of any signal pulses appearing thereon. If the amplitude of a given ECG signal pulse exceeds a prescribed threshold level for a prescribed time period, the pulse is considered to be a valid ECG signal. The noise discrimination circuit includes: a threshold detector for determining if the amplitude of the ECG signal exceeds the prescribed threshold level; a timer circuit for generating a timed window signal, triggered by the threshold detector whenever the ECG signal amplitude exceeds the prescribed threshold level; and logic circuitry for determining if the amplitude of the ECG signal remains above the threshold level for the duration of the timed window signal.

Abstract: A pacemaker and physiological sensor for use therewith that allows the rate at which the pacemaker delivers electrical stimulation pulses to the heart, or the escape interval during which a natural heart event must occur before an electrical stimulation pulse is delivered, to be adjusted as needed in order to satisfy the body's physiological needs. The sensor measures the depolarization time interval between an atrial stimulation pulse, A, and the responsive atrial or ventricle depolarization, P or R respectively, as an indication of the physiological demands placed on the heart. The time interval between a ventricular stimulation pulse, V, and the responsive ventricular depolarization, R, may also be measured and used as an indication of physiological need, and hence as an alternative criteria for rate control. Atrial depolarization is sensed by detecting a P-wave, and ventricular depolarization is preferably sensed by detecting an R-wave.